LEWIS'S MEDICAL-SURGICAL NURSING
ASSESSMENT AND MANAGEMENT OF
CLINICAL PROBLEMS, SINGLE VOLUME
12TH EDITION
• AUTHOR(S)MARIANN M. HARDING;
JEFFREY KWONG; DEBRA HAGLER;
COURTNEY REINISCH
TEST BANK
1
Reference: Ch. 1 — Professional Nursing — Domain of Nursing
Practice
Stem: A newly graduated RN is orienting to a medical-surgical
unit and is asked to prioritize tasks for three assigned patients.
Which approach best demonstrates understanding of the
domain of nursing practice when establishing priorities?
A. Assign tasks by acuity, addressing
airway/breathing/circulation first.
,B. Complete the easiest tasks first to maximize efficiency.
C. Follow the written physician orders sequentially, regardless of
condition.
D. Prioritize patients by length of stay to ensure discharge
planning.
Correct answer: A
Rationale — Correct (A): Prioritizing by acuity and addressing
ABCs aligns with nursing’s domain of promoting safety and
physiological stability. Lewis emphasizes assessment-driven
priority setting and risk reduction. Using clinical judgment to
identify immediate threats is core to safe nursing practice.
Rationale — Incorrect:
B — Working easiest-first may delay critical interventions and
risks patient harm.
C — Physician orders are important but must be balanced with
immediate patient needs; orders aren’t always highest priority.
D — Length of stay is not a clinical priority when acuity dictates
urgent intervention.
Teaching point: Always prioritize by patient acuity and
immediate threats (ABC and safety).
Citation: Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C.
(2023). Lewis’s Medical-Surgical Nursing (12th Ed.). Ch. 1.
2
Reference: Ch. 1 — Professional Nursing — Definitions of
Nursing; Nursing’s View of Humanity
,Stem: A nurse is planning care for a patient with chronic heart
failure who expresses fear about independence loss. Which
nursing action best reflects nursing’s view of humanity and
holistic care?
A. Create a plan emphasizing medical tasks and medication
adherence.
B. Explore the patient’s concerns, involve family, and set goals
supporting autonomy.
C. Refer the patient to social work and continue routine
monitoring.
D. Focus on teaching about disease process and diet changes.
Correct answer: B
Rationale — Correct (B): Lewis frames nursing as holistic,
addressing psychosocial as well as physiological needs.
Exploring fears and involving family supports patient-centered
care and respects human dignity. This approach uses clinical
judgment to integrate patient values into the care plan.
Rationale — Incorrect:
A — Medication focus ignores psychosocial dimensions and
patient fears.
C — Referral is helpful but delegating the emotional work alone
misses therapeutic nurse–patient relationship duties.
D — Disease teaching is important but insufficient without
addressing emotional concerns and autonomy.
Teaching point: Holistic nursing addresses physiological and
psychosocial needs to support autonomy.
, Citation: Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C.
(2023). Lewis’s Medical-Surgical Nursing (12th Ed.). Ch. 1.
3
Reference: Ch. 1 — Professional Nursing — Standards of
Professional Nursing Practice
Stem: An RN evaluates a new unit policy that changes
frequency of neuro checks after stroke. Which action best
demonstrates adherence to standards of professional nursing
practice?
A. Implement the policy immediately without question.
B. Compare the policy to current evidence and advocate for
revisions if needed.
C. Ignore the policy and continue previous practices.
D. Ask the charge nurse to decide but make no further inquiry.
Correct answer: B
Rationale — Correct (B): Lewis emphasizes nurses’
responsibility to use evidence and professional standards.
Evaluating policy against best evidence and advocating for
change reflects professional accountability and clinical
judgment. This protects patient safety and aligns practice with
EBP.
Rationale — Incorrect:
A — Blind compliance can perpetuate non-evidence-based care.
C — Ignoring policy undermines team cohesion and may violate
institutional rules.
ASSESSMENT AND MANAGEMENT OF
CLINICAL PROBLEMS, SINGLE VOLUME
12TH EDITION
• AUTHOR(S)MARIANN M. HARDING;
JEFFREY KWONG; DEBRA HAGLER;
COURTNEY REINISCH
TEST BANK
1
Reference: Ch. 1 — Professional Nursing — Domain of Nursing
Practice
Stem: A newly graduated RN is orienting to a medical-surgical
unit and is asked to prioritize tasks for three assigned patients.
Which approach best demonstrates understanding of the
domain of nursing practice when establishing priorities?
A. Assign tasks by acuity, addressing
airway/breathing/circulation first.
,B. Complete the easiest tasks first to maximize efficiency.
C. Follow the written physician orders sequentially, regardless of
condition.
D. Prioritize patients by length of stay to ensure discharge
planning.
Correct answer: A
Rationale — Correct (A): Prioritizing by acuity and addressing
ABCs aligns with nursing’s domain of promoting safety and
physiological stability. Lewis emphasizes assessment-driven
priority setting and risk reduction. Using clinical judgment to
identify immediate threats is core to safe nursing practice.
Rationale — Incorrect:
B — Working easiest-first may delay critical interventions and
risks patient harm.
C — Physician orders are important but must be balanced with
immediate patient needs; orders aren’t always highest priority.
D — Length of stay is not a clinical priority when acuity dictates
urgent intervention.
Teaching point: Always prioritize by patient acuity and
immediate threats (ABC and safety).
Citation: Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C.
(2023). Lewis’s Medical-Surgical Nursing (12th Ed.). Ch. 1.
2
Reference: Ch. 1 — Professional Nursing — Definitions of
Nursing; Nursing’s View of Humanity
,Stem: A nurse is planning care for a patient with chronic heart
failure who expresses fear about independence loss. Which
nursing action best reflects nursing’s view of humanity and
holistic care?
A. Create a plan emphasizing medical tasks and medication
adherence.
B. Explore the patient’s concerns, involve family, and set goals
supporting autonomy.
C. Refer the patient to social work and continue routine
monitoring.
D. Focus on teaching about disease process and diet changes.
Correct answer: B
Rationale — Correct (B): Lewis frames nursing as holistic,
addressing psychosocial as well as physiological needs.
Exploring fears and involving family supports patient-centered
care and respects human dignity. This approach uses clinical
judgment to integrate patient values into the care plan.
Rationale — Incorrect:
A — Medication focus ignores psychosocial dimensions and
patient fears.
C — Referral is helpful but delegating the emotional work alone
misses therapeutic nurse–patient relationship duties.
D — Disease teaching is important but insufficient without
addressing emotional concerns and autonomy.
Teaching point: Holistic nursing addresses physiological and
psychosocial needs to support autonomy.
, Citation: Harding, M. M., Kwong, J., Hagler, D., & Reinisch, C.
(2023). Lewis’s Medical-Surgical Nursing (12th Ed.). Ch. 1.
3
Reference: Ch. 1 — Professional Nursing — Standards of
Professional Nursing Practice
Stem: An RN evaluates a new unit policy that changes
frequency of neuro checks after stroke. Which action best
demonstrates adherence to standards of professional nursing
practice?
A. Implement the policy immediately without question.
B. Compare the policy to current evidence and advocate for
revisions if needed.
C. Ignore the policy and continue previous practices.
D. Ask the charge nurse to decide but make no further inquiry.
Correct answer: B
Rationale — Correct (B): Lewis emphasizes nurses’
responsibility to use evidence and professional standards.
Evaluating policy against best evidence and advocating for
change reflects professional accountability and clinical
judgment. This protects patient safety and aligns practice with
EBP.
Rationale — Incorrect:
A — Blind compliance can perpetuate non-evidence-based care.
C — Ignoring policy undermines team cohesion and may violate
institutional rules.
